| Objective:By detecting the expression levels of IL-31 and IL-33 in effusion pleural effusion(TPE,MPE and PPE),the differential diagnostic value of IL-31 and IL-33 was discussed,and the correlation and diagnostic value of IL-31 and IL-33 were analyzed together with pleural effusion ADA.Methods:Patients admitted to the respiratory and critical care Department of the Second Affiliated Hospital of Nanchang University for pleural effusion due to unknown reasons from March 2021 to December 2021 were treated with pleural puncture within 24 hours after exclusion of contraindications.Pleural effusion samples were collected for routine pleural effusion,biochemical examination,pleural effusion CEA and pleural effusion cytology examination.At the same time,10 ml of fresh pleural effusion was collected after centrifugation and frozen.A total of 63 patients were selected according to the inclusion and exclusion criteria,including 30 patients with TPE,21 patients with MPE,and 12 patients with PPE.The concentrations of IL-31 and IL-33 in pleural effusion were detected by ELISA.SPSS 26.0 statistical software was used to analyze and compare the expression levels of IL-31 and IL-33 in pleural effusion of each group,and ROC curve was drawn.The diagnostic efficacy of single detection and combined detection of each indicator was compared according to the area under the curve,and the corresponding sensitivity,specificity,Yuden index and optimal cut-off value were calculated.To evaluate the diagnostic value of detection indexes for TPE,and Spearman correlation analysis was used to analyze the correlation of IL-31,IL-33 and pleural ADA indexes.Results:1.Comparison of IL-31,IL-33 and ADA expression levels in pleural effusion:The highest levels of IL-31,IL-33 and ADA in TPE group were 4.10(3.51,5.17)pg/m L,395.46(355.21,441.87)pg/ml,32.11(13.46,43.91)U/L,respectively.The expression levels of the three indicators were significantly different between TPE and MPE groups(P < 0.05).The expression levels of IL-31 and IL-33 showed no significant difference between TPE and PPE(P > 0.05).2.Diagnostic value of IL-31,IL-33 and ADA tests for TPE: ROC curve was drawn.The AUC of IL-31,IL-33 and pleural ADA were 0.738,0.756,0.829,Yuden indexes were 0.581,0.547,0.633,and the optimal cut-off values were 3.368 pg/ml and 338.044pg/ml,respectively.21.745U/L,corresponding sensitivity and specificity were 86.9% and 71.4%,83.3% and 71.4%,63.3% and 100%,respectively.3.Diagnostic value of combined IL-31,IL-33 and ADA tests for TPE: ROC curve was drawn.The AUC corresponding to IL-31+ADA,IL-33+ADA and IL-31+IL-33+ADA were 0.837,0.857 and 0.873,and the Yoden index was 0.633,0.619 and 0.700,respectively.The corresponding sensitivity and specificity were63.3% and 100%,66.7% and 75.2%,70.0% and 100%,respectively.4.Correlation analysis of IL-31,IL-33 and pleural ADA in TPE and MPE showed that pleural ADA was positively correlated with IL-31 and IL-33,with correlation coefficients of 0.441 and 0.432,respectively,and P < 0.01 was statistically significant(P < 0.05).There was a significant positive correlation between IL-31 and IL-33,with a correlation coefficient of 0.852(P < 0.01).Conclusion:1.The expression levels of cytokines IL-31 and IL-33 in TPE were significantly higher than those in MPE,and the diagnosis of TPE had good sensitivity and specificity.2.The combined detection of IL-31,IL-33 and pleural ADA is better than single detection in the diagnosis of TPE;3.There was a moderate positive correlation between IL-31 and IL-33 and pleural ADA in TPE and MPE,suggesting that IL-31 and IL-33 have important diagnostic value for TPE. |
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